Leukemia is the only thing countless people know about blood diseases. Incurable disease, pain, despair, the most incurable disease among cancers... Leukemia has been continuously demonized in the past few decades, even to the point of terrifying
situation.
In fact, leukemia is not that scary. As a disease with ten types, most leukemias can actually be controlled through drugs and radiation therapy. There are only m0 acute myeloid leukemia, microdifferentiated type, and mal acute
Mixed leukemia has a poor prognosis.
But no matter what, leukemia is still a disease that is difficult to treat. Especially when this disease appears in the elderly, treatment becomes even more difficult. Except for m3 leukemia, almost all other leukemia treatments rely on bone marrow.
transplant.
In order to prevent the transplanted bone marrow from causing rejection in the body, in addition to taking anti-rejection drugs that suppress the immune system after the transplant, doctors also need to kill the patient's own bone marrow through radiotherapy before the transplant.
Do you want to give radiotherapy to an 88-year-old elderly person who has multiple underlying diseases and is likely to have infection? It would be better to give her a knife directly, so as to save her suffering.
Sun Lien's heart was in turmoil. He could only pray silently for the old man in the hospital bed. If it was an infection, it must be an infection. At least if it was an infection, there was still a chance of winning. But if it was really leukemia, then...
There is absolutely no other way.
Zhou Jun has worked in the hospital for many years. Over the years, countless patients with acute leukemia have been admitted to the emergency room. As for the final conditions of these patients, Zhou Jun also knows a lot about the patients who were sent to the emergency room because of acute leukemia.
I can count on two hands the number of people who walked out of the emergency room on their own. And not one of them survived for more than five years.
After a long silence, Zhou Jun whispered, "Let's wait for the test results." He paused, "I'll contact Professor Li to see if there are any beds in the hospital's Department of Hematology."
Ningyuan Medical College has a long history, and the Department of Transfusion Medicine under the School of Biotechnology is strong. Professor Li, who is also the director of the Department of Hematology at the Fourth Central Hospital, is a leader in the research of tumor immunity.
Zhou Jun agreed with Sun Lien. Now it is just a choice between two options, either leukemia or lung infection. He looked bitter and said in a bitter voice, "I really didn't expect that..."
I didn't expect that my grandmother would suffer such a crime, I didn't expect that I would face such troubles, and I didn't expect that one day I would be so powerless.
"The results are out." Xu Yourong, who had been waiting in the CT room, walked out and said to the worried master and apprentice, "The pleural effusion is about 800 ml. There is also abdominal effusion, which is 300 ml.
There are signs of splenomegaly at the same time." She looked worried and said, "Dr. Zhou, this doesn't look like an infection."
Sun Lien patted Zhou Jun's shoulder and said to Xu Yourong, "First remove the pleural effusion, drain the old lady's effusion, and then arrange for a bone marrow puncture."
Zhou Junqiang cheered up and said, "I'm going to ask Professor Li about the hospital bed." He took two steps away, grabbed his father, turned to Sun Li'en and said, "Li'en, the old lady is asking you.
Already."
Sun Lien nodded and said nothing. Xu Yourong, who was standing next to him, did not show any dissatisfaction after being commanded. Instead, he asked curiously, "Do you have any suspicions?"
"These symptoms are combined together, and I don't feel very good." Sun Lien was careful to avoid using the word "leukemia". He considered his words and said, "If it is just infection, abdominal hydrops and changes in mental status cannot be justified. If it is himself.
Immune diseases will not progress so fast. If it is a simple cardiopulmonary circulatory disease, then there is no source of abdominal fluid." He sighed, "Exclude these three, and the rest is the answer."
"Tumor?" Xu Yourong raised his eyebrows, "But there is no fever."
"Same as when Xiaolin Xun was diagnosed, the symptoms were covered up." Sun Lien said helplessly, "She had hypothermia after sitting in the cold wind for several hours."
"I'll arrange another blood tumor marker test." Xu Yourong understood what Sun Lien meant, and she suddenly paused, "I'm already eighty-eight..."
"Treatment is definitely risky." Sun Lien also sighed, "I hope it's not m0 type."
Zhou Xiufang's routine blood test results were waiting in the emergency room. As indicated by the status bar, the old man's hemoglobin was only 65g/l, nearly half lower than the reference value. The immunoglobulin IgG was as high as 63.1g/l, which was
About four times the reference value.
In the emergency room, Nurse Zhong used a syringe to draw Zhou Xiufang's first pleural effusion. Four tubes were drawn out with a large 100 ml syringe. One of the tubes was also sent to the laboratory for pleural effusion cytology examination.
There was no other option but to wait. Sun Lien had never felt so powerless. He sat blankly behind the duty desk, looking at the patients lying on the hospital bed. Sun Lien even hated his own incompetence. If he could no longer
Study more, be more serious when taking classes in medical school... maybe you can figure out a solution.
"What are you thinking about?" Xu Yourong came over with two piles of information. Seeing Sun Lien who was in a daze, he couldn't help but curiously asked, "Thinking about diagnosis?"
"I regret that I didn't listen carefully when I was in school." Sun Lien squeezed a smile from his face, "If I had listened carefully again, maybe there would be something I could do."
Xu Yourong asked curiously, "How good are domestic undergraduate programs now? Can you know how to treat unknown diseases by listening carefully in class?"
Sun Lien was choked so much that he almost couldn't breathe.
"First of all, we need to make a clear diagnosis, and to make a clear diagnosis, we need to wait for further results from the laboratory." Xu Yourong shrugged, "In the past, it was difficult for a clever woman to make a meal without rice, but now you don't even have a stove, let alone rice.
What’s the use of listening carefully?”
Although Xu Yourong spoke directly, his words made sense. Sun Lien suddenly felt that the pressure in his heart was much less.
"We are doctors, not gods." Xu Yourong placed two piles of information in front of Sun Lien and continued, "Many patients don't even have a correct diagnosis and die because of the rapid progression of their illness. You have done a very good job." She said.
She patted the documents she had brought and said, "These are the resumes of people who are interested in coming for interviews." She paused and continued, "The resumes of Brun and Pascal are also in it, but since Director Liu is so interested in them,
I suggest you at least let them come for an interview first."
"Interview?" Sun Lien pointed at himself blankly, "I'll interview them?"
"You are the leader." Xu Yourong found a stool and sat down, tapping the table with his hand, "If you don't come for the interview, how about I?"
"I thought I just invited someone to join me." Sun Lien picked up the resume in front of him, still feeling like he was dreaming, "I was interviewed just a few months ago, and now I have to interview someone else again?"
Xu Yourong chuckled and said, "Then you'd better adapt to this change in your role as soon as possible." She said seriously, "The interview is a very important part. Job seekers will also use you to understand the future of the team and what they care about.